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Colorado Cancer Resource

If you could prevent cancer by simply going for an annual screening at your doctor’s office, you would think that most people would do it. However, skin cancer, which is one of the most common forms of cancer and one of the easiest to diagnose, causes more than two deaths every hour. According to a study by National Institute of Health (NIH) only 8% of patients interviewed who had seen either a primary care or ob/gyn provider within the last year had received a skin examination.

Why is the rate so low? Perhaps we have other pressing health concerns, screenings or ailments? We’re often too busy, or think we’re too young, too healthy to ever get sick. Skin cancer only happens to other people, right?

The truth is early detection through regular screenings can prevent more than 98% of skin cancer deaths, which means virtually every death. How could dermatologists encourage more people to get screened? What if you could upload a photo of a skin lesion from the comfort of your own home for screening, as easily as you could post an Instagram photo?

“Most people who use our app are people who would not otherwise go to a dermatologist,” – Charu Singhal

Making A Difference | Meet Charu Singhal of Etta Epidermis

Enter Etta Epidermis, a web-based artificial intelligence software program that instantly analyzes photos of skin lesions and assesses them as low, medium, or high risk. If you knew that mark on your hand looked high risk, you’d probably be more motivated to get to your dermatologist, wouldn’t you?

Etta Epidermis was the brainchild of Charu Singhal (pictured left), a machine learning engineer from Chicago, IL, and CEO of Etta. As a 26-year-old creative writing, music composition, and Peace Studies undergrad, Singhal might seem an unlikely co-founder, along with CTO Joanna Zurawek (pictured right), of a skin cancer detection app.

“I have a lot of people in my life that were touched by a skin cancer death, and it was very shocking,” Singhal explains. “I always had a perception that skin cancer was something that you just have cut off, and then you’re OK. I also thought, like many people of color, that people of color don’t get skin cancer.”

When someone close to her died, someone who was young and a person of color, her thinking radically changed, and so did her career goals. Another experience that changed her was seeing how technology could help people on a mass scale.

Her first job out of college was as an elementary school teacher in Chicago. She had little experience teaching but was fortunate to be able to harness the power of classroom apps because local startups were making them available to schools. She noticed her students were better able to understand classroom lessons after using the app for just a week.

“I thought, wow, this app, in one week, has done way better at explaining content to my students than I’ve been able to do in months,” Singhal said. “It was like a light bulb … one person helping one person is one to one, but this can help every kid at every school.”

Soon after that, Singhal learned to code in her free time and then enrolled in a master’s program for computer science, with a focus on machine learning. She built her first startup tech company while in grad school called SYLLBA, which was a data-sharing platform for teachers. “I was only 22 and didn’t know how to build a business, so I had to make all the mistakes one that one could make,” she says.

Fortunately, she was able to use that learning to help her build her next startup, Etta. But, first, she worked in a private equity firm to make enough money to help sustain her through the building phase. She wanted to be able to fully dedicate herself to the business.

She built the data engine for Etta during her 45-minute train ride commutes to and from work over the course of a few months. Her co-founder created a user interface and web application infrastructure, and then they started testing it out on people. To take their business to the next level, they applied and were accepted to the Boomtown Accelerator Program in Boulder. Why Boulder?

“I lived in Chicago my whole life, and I was getting so tired of spending my winter just inside. I had read that Boulder and Denver were areas where healthcare startups were growing and were affordable areas to live.” They ultimately partnered with Colorado Dermatology Institute to help build out its database.

The two founders screened people during a demo day at the accelerator program. They screened their friends. They screened people on the street. Those people posted on social media about the app, and then it went viral, which got them more users. Soon, they had screened over 3,000 people.

The way the web-based app works is that you take a photo of a lesion, upload it, and the app analyzes your lesion against massive data-sets of hospital-verified images. Within seconds you receive an assessment of low, medium, or high risk. For a nominal fee, you store your photos on the app so you can see if they change over time. Changes in size, shape, or color of lesions can be an indicator of skin cancer.

Once people started going to their dermatologists, armed with information from Etta, Singhal began to get calls from dermatologists asking to partner with her. Singhal and her team began forming partnerships with dermatology clinics and emergency departments in Colorado and around the country.

“Most people who use our app are people who would not otherwise go to a dermatologist. We get a lot of accounts made on behalf of loved ones,” says Singhal. “For example, while a wife may not be able to urge her husband to make an annual skin check appointment, she can always snap a picture of him, and if the app says that a mole is a high risk, he may make an appointment on his own.”

Since launch, Singhal says that 43 people have reached out and informed her that Etta detected a cancerous lesion that was eventually removed by a dermatologist.

Moving Forward

Etta Epidermis is working with Emergency Departments to integrate into existing tools and help them screen deadly rashes, infections and automatically generate dermatology consults. They are also working with pediatric departments to develop a screening tool for lupus and other autoimmune diseases that are difficult to assess in children.

Etta Epidermis has recently partnered with Healthgrades.com to help their dermatology patients receive timely specialist appointments, simultaneously helping dermatologists assess severity of skin conditions in times when it may be difficult to book in-person appointments and Dermatologists are required to utilize telehealth for public health measures. They are also working on a public research initiative to aid in the screening of Dermatological manifestations of Covid-19.

Did You Know?

Skin cancer is the most common cancer in the United States and worldwide. (Source) Skincancer.org

1 in 5 Americans will develop skin cancer by the age of 70.

More than 2 people die of skin cancer in the U.S. every hour.

Having 5 or more sunburns doubles your risk for melanoma.

When detected early, the 5-year survival rate for melanoma is 99 percent.